Interstitial Cystitis

Definition

An inflammation of the bladder wall. Interstitial cystitis has symptoms similar to cystitis (bacterial infection of the bladder), but urine cultures are negative for bacteria and antibiotics usually do not help. The average age of onset is 40, but it affects women of all ages. Symptoms range from mild to severe.

Signs and Symptoms

  • Pelvic pain and pressure.
  • Urgent need to urinate (sometimes 60 to 80 times a day) and burning during urination.
  • Sensation of incomplete emptying of the bladder.
  • Pain during sexual intercourse.
  • Vaginal and rectal pain (sometimes).

Causes

Exact cause is unknown. Studies suggest that it is a syndrome of bladder inflammation possibly initiated by bacterial infection, autoimmune process (misdirected immune response in which the body’s defenses become selfdestructive) or contact irritants. It is probably not an infectious disease.

A history of sensitivities or allergies to medications, food, or other substances; hay fever or asthma.

Treatment

  • Initial diagnostic tests will include urine studies (which are usually normal) and a pelvic examination. Conditions that have similar symptoms (bladder infection, kidney problems, vaginal infections, endometriosis, and sexually transmitted diseases) will need to be excluded.
  • If other tests are negative, a cystoscopy (use of a small lighted telescope to view the inside of the bladder) is often recommended. A biopsy is taken at this time to rule out a malignancy. As an added benefit, cystoscopy often helps relieve symptoms. It involves distention of the bladder by filling it with water, thereby stretching the bladder and increasing its capacity.
  • There is no consistently effective treatment for the disorder. Options include various oral medications, medication instilled into the bladder, special routines for stretching the bladder, diet changes, bladder retraining, relaxation training.
  • Counseling, biofeedback or self-hypnosis or self-relaxation therapy is recommended to help manage the stress, anger, anxiety and, sometimes, depression that accompanies disorders of chronic pain.
  • Surgical measures such as a Hydroextention of the bladder could be recommended by your medical provider.

Medications

  • Antihistamines, anticholinergics, nonsteroidal anti-inflammatory drugs (NSAIDs), and antidepressants all have limited success with decreasing the symptoms.
  • DMSO (dimethyl sulfoxide) or other medications may be instilled (placed directly) into the bladder. The DMSO is left in for about 15 minutes and then expelled. The treatment is repeated every 2 weeks or until symptoms are relieved and then repeated as needed. DMSO use produces a garlic-like smell to the skin and breath lasting up to 72 hours.

 

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